Neurodevelopmental physical therapy improves spasticity in children with CP

A physical therapy approach known as neurodevelopmental treatment can improve shaking but not movement in children with cerebral palsy, according to a South Korean study in the Journal of Physical Therapy Science.

Neurodevelopmental physical therapy is shown to improve spasticity, but not movement, in some children with CP. CP Family Network‏@cpfamilies August 1, 2017

Physical therapy is often necessary to address movement problems, but researchers have disagreed on the best approach.

Neurodevelopmental treatment, or NDT, is a hands-on approach to improving movement in patients with CP,stroke, or head injury. It involves guiding a patient’s movements. Proponents say it allows a physical therapist to assess and analyze movements while training patients.

South Korean researchers decided to investigate the effects of a year of NDT physical therapy on the muscle strength, spasticity, and movement of children with CP.

The study included 175 children with spastic cerebral palsy, aged 3 to 18. The children had NDT physical therapy 35 minutes a day, two to three times a week, for a year. The research team measured muscle strength, spasticity and movement abilities before and after the therapy.

The majority of patients – 112 – were classified as level III-V. Sixty-three patients were categorized as level I-II.

After a year of the therapy, researchers discovered that only changes in patients’ spasticity were significantly different: It decreased. There were no changes in their muscle strength or movement abilities.

Spasticity differed between the GMFCS levels, researchers added. It decreased more among children classified as GMFCS III-IV than in those classified as I-II. In contrast, muscle strength in children at GMFCS levels I–II improved more than in levels III–V. No significant improvement in movement ability was seen in either group.

“Neurodevelopmental treatment-based physical therapy in children with cerebral palsy seems to be effective in reducing spasticity, but does not improve gross motor function,” the team wrote. “Therefore, other interventional approaches are needed to improve gross motor function [movement ability] in children with cerebral palsy.”